False Claims Act Update & Alert
Taxpayers Against Fraud Education Fund | Washington, D.C. | WWW.TAF.ORG December 6, 2004
		Sign Up for this FREE Newsletter n Web Site n About TAF-EF n The False Claims Act n Previous newsletters n Email editor Please take a moment to forward this FREE electronic newsletter to others that might be interested!	TAF Report: $2.4 Billion is Just The Tip of Drug Fraud Iceberg A new study from the Taxpayers Against Fraud Education Fund reports that over $2.4 billion has been recovered from drug manufacturers engaged in fraud against the U.S. Government and the 50 states. "This is just the tip of the iceberg," notes James Moorman, President of the TAF Education Fund. "The Department of Justice reports that over 500 drugs are under investigation right now, and we believe many very large fraud cases are still under seal." >> To read the study and the release
			Gambro to Pay $350 Million Gambro Healthcare, the nation's third-largest operator of renal-dialysis clinics, has agreed to pay $350 million to settle charges it defrauded Medicare. The case was brought to the U.S. Government by Dr. Steven Bander, a former Gambro medical officer. The fraud included Gambro paying kickbacks to physicians for referrals to the company's clinics, Gambro setting up a sham company to feed inflated bills to Medicare, and the falsification of bill and statements to patients justifying unnecessary tests and services. >> To read more
			Medco Allegedly Offered $200 M Kickback to Health Plan Documents filed by the U.S. Attorney's Office in Philadelphia allege that Medco, the nation's largest pharmacy benefits manager, offered more than $200 million in kickbacks to a managed-care company to win contracts. The recipient managed care company wasn't named, but this is the second time that Medco has been accused of making kickbacks to a large health insurer. In the first instance, more than $87 million in kickbacks were paid to Oxford Health Plan over just two quarters in 2001. In documents filed with the court, the Justice Department has asked for an extension of discovery in order to go through nearly 400,000 pages of documents delivered on CD-Roms in the last 8 days of discovery. The documents on the CDs are not electronically searchable, eight of them were broken, and the index supplied is nearly worthless according to the Government. In other electronic files delivered to the Government the day before Thanksgiving, every line of data was electronically "locked" and encrypted in order to make them nearly impossible to use. >> To read more
			Hospital Was Overpaid $280 M The Inspector General of Health and Human Services reports that the lllinois Medicaid program overpaid the University of Illinois at Chicago Hospital (UIC) $280.6 million between 1997 and 2000. This money was related to "disproportionate share" hospital payments made to hospitals that serve large numbers of low-income, special needs patients. DSH payments are supposed to be limited to hospitals' uncompensated care costs to Medicaid and uninsured patients. Half of the overpayments made to UIC Hospital were made with federal matching funds. >> To read the HHS OIG report (PDF)
			TAP to Pay $150 M More TAP Pharmaceutical Products Inc. has agreed to pay $150 million to settle insurance company and patient lawsuits related to the pricing and marketing of its prostate-cancer drug Lupron. TAP paid a record $885 million in 2001, and pleaded guilty to a criminal charge, to settle federal charges related to the illegal marketing and pricing of Lupron. With the new payout, TAP's Lupron settlements now total more than $1 billion. >> To read more
			$2.2 M Loma Linda PATH Fraud A group of faculty practice corporations affiliated with Loma Linda University has paid the United States $2.2 million to resolve allegations they submitted false claims to Medicare. The settlement was paid after 20 corporations reached an agreement to conclude a federal fraud investigation. >> To read more
			Rebate Records Protection In response to pressure from Senator Charles Grassley (R-IA), Taxpayers Against Fraud, and federal and state law enforcement officials, the Center for Medicare and Medicaid Services (CMS) has published a rule finalizing a 10-year recordkeeping requirement for drug companies participating in the Medicaid drug rebate program. >> To read TAF's comments >> To view the final rule
			PolyMedica Settles for $35 M PolyMedica reports it will pay $35 million to settle fraud charges made by the U.S. Department of Justice. The government charged PolyMedica, and its Liberty Medical Supply subsidiary, with shipping diabetes test strips to people who didn't order them and not reimbursing Medicare for returned packages. Liberty Medical is a major TV advertiser of diabetes products. >> To read more